{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,7]],"date-time":"2026-07-07T14:16:06Z","timestamp":1783433766431,"version":"3.54.6"},"reference-count":39,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2026,6,12]],"date-time":"2026-06-12T00:00:00Z","timestamp":1781222400000},"content-version":"vor","delay-in-days":11,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,6,1]],"date-time":"2026-06-01T00:00:00Z","timestamp":1780272000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Euro J of Neurology"],"published-print":{"date-parts":[[2026,6]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Moyamoya angiopathy (MMA) is a cerebrovascular disease treated by surgical revascularization. This study aimed to present long\u2010term outcomes of European MMA patients after surgical revascularization.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>MMA patients treated surgically between 1998 to 2023 were included. Follow\u2010up comprised clinical and radiological examinations and electronic questionnaires. Patient data were analyzed retrospectively, and logistic regressions were performed to identify predictors of unfavorable outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of 276 patients with 428 surgically treated hemispheres were included. The mean age was 35.0\u2009\u00b1\u200917.2\u2009years, including 192 women and 84 men, predominantly of Caucasian ethnicity (88.0%). Ischemia (82.2%) and hemorrhage (10.1%) were the most common symptoms at onset. Most adults (80.9%) were treated with combined bypass surgery via mini\u2010craniotomy. Within 30\u2009days, complications occurred in 6.3% of surgeries, and the perioperative stroke risk was 2.6%. A total of 148 patients underwent in\u2010house follow\u2010up. No mRS scores \u2265\u20095 were observed, with 86.3% of patients achieving a score of 0\u20132, alongside a bypass patency rate of 95.7% and a stroke risk of 0.3% per patient\u2010year. Preoperative stroke and silent ischemic MRI lesions were identified as predictors of an unfavorable outcome. Additionally, 201 patients were followed up electronically. No mRS scores \u2265\u20095 were observed, with 87.9% of patients achieving a score of 0\u20132. Moreover, 90.7% were independent in daily life, but only 50.5% returned to work or school.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Combined bypass surgery yielded favorable outcomes with low complication and stroke rates. Patients with preoperative stroke require closer follow\u2010up, and individualized strategies are needed to address persistent functional impairments.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/ene.70664","type":"journal-article","created":{"date-parts":[[2026,6,13]],"date-time":"2026-06-13T03:12:40Z","timestamp":1781320360000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Clinical Efficacy of Revascularization Surgery for Moyamoya Angiopathy: Long\u2010Term Results of a European Cohort"],"prefix":"10.1111","volume":"33","author":[{"given":"Robert","family":"Mertens","sequence":"first","affiliation":[{"name":"Department of Neurosurgery Charit\u00e9 \u2013 Universit\u00e4tsmedizin Berlin  Berlin Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ibrahim","family":"Efe","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery University Hospital 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